News survey for September 19, 2022

Fatigue and brain fog rise 9 months after mild COVID-19 infection

About 9 months after infection with COVID-19, 19% of out-of-hospital adult patients in the German group experienced fatigue, 26% had mild cognitive impairment (“brain fog”), and 1% had moderate cognitive impairment, According to a multicenter study.

The study, published late last week in Clinical Medicinealso showed that the incidence and risk factors for fatigue and cognitive impairment differ by age group.

The researchers administered the FACIT Fatigue Scale and the Montreal Cognitive Assessment to 969 participants who tested positive for COVID-19 at least 6 months prior in three German hospitals from November 15, 2020 to September 29, 2021. A total of 55% of patients were women. Patient outcomes were compared with those of 969 matched controls from a pre-pandemic population-wide survey.

On average 9 months after infection with COVID-19, 19% experienced clinically-related fatigue, compared to 8% of the control group. Risk factors included female gender, younger age, history of depression, altered consciousness, dizziness, and muscle pain—but not disease severity—during acute infection. “This suggests that the affected organ systems, particularly the central and peripheral nervous system injury, are more relevant to the development of fatigue than the overall severity of the disease,” the authors wrote.

A total of 26% of patients had mild cognitive impairment—about twice as much as would be expected—and 1% had moderate cognitive impairment. Risk factors for poor cognition include old age, male gender, low educational attainment, and a history of neuropsychiatric disease.

The association between fatigue and cognitive impairment was minimal, and only 5% of patients had both conditions, 14% had only fatigue, and 22% had only cognitive impairment. While fatigue tends to improve over time, the onset of cognitive impairment appeared to be delayed by several months.

“Fatigue and cognitive impairment are common, but distinct sequelae of COVID-19 with potentially separate pathophysiological pathways,” the researchers wrote.

The team added that these persistent conditions may place a significant burden on the health system. “Patients with post-COVID stress will need professional assistance, for example through specialized multidisciplinary outpatient clinics and rehabilitation programmes,” they wrote.
September 17 Clinical Medicine study

Extra Diabetic Weight, Not Blood Sugar, Linked to COVID-19, COVID Long

Adults with diabetes and a high body mass index (BMI), but not elevated blood sugar levels, are at greater risk of developing COVID-19 and prolonged COVID infections, according to a meta-analysis of more than 30,000 UK adults from nine presented cohort studies. At the annual meeting of the European Association for the Study of Diabetes (EASD) to be held this week in Stockholm, Sweden.

Dr Annika Knoble, the study’s lead researcher from University College London, said in an EASD press release.

To conduct the study, researchers combed through nine major studies from the United Kingdom to look at self-reported cases of COVID-19 and prolonged COVID infection in adults and associations with levels of HbA1c (mean blood glucose), self-reported or drug-based diabetes, Body mass index and waist-hip ratio.

The 31,252 participants were between 19 and 75 years old, and 57% were women.

The researchers found that people whose BMI was overweight (25 to 29.9 kg/m2) or obesity (30 kg / m2 or greater) with 10% and 16% odds of contracting COVID-19, respectively, compared to individuals of a healthy weight. For long-term Covid, the association was even greater, with overweight people having 20% ​​higher odds, and obese people having 36% higher odds.

Mean blood glucose level and diabetic status revealed no association with COVID-19 or prolonged COVID-19.
September 16 EASD
press release